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For most patients with allergic rhinitis, nasal congestion is the most bothersome symptom. Oral pseudoephedrine is effective for nasal congestion, but federal laws have limited its availability because of its use in methamphetamine production. Phenylephrine, another over-the-counter oral decongestant, is more readily available, but data on its efficacy are limited. In this open-label trial, U.S. investigators randomized 539 adults with allergic rhinitis to phenylephrine (10, 20, 30, or 40 mg) or placebo for 7 days.
Daily nasal congestion scores did not change significantly from baseline in the active-treatment groups or in the placebo group. A total of 14% of phenylephrine patients experienced adverse nervous system or gastrointestinal event…